Working with Stigma
I have written on a number of occasions in recent years about the subject of stigma and the impact it has on the health and welfare of not only people who use drugs, but also the wellbeing of their friends and families. After working on several posters dealing with the subject recently I thought it might be time to revisit the stigmatisation of people who use drugs in writing.
The Impact of Stigma
The stigmatisation of people who use drugs only pushes drug use to the hidden margins of our communities, decreasing adequate access to the resources that enable good health. Ultimately stigmatisation can lead to practices that pose potentially greater risk and sadly in some instances death. When considering the challenges involved in addressing the stigmatisation of people who use drugs, it can at times feel insurmountable. The stigma associated with the use of drugs (in particular those deemed illicit by our society) appears so widespread and deeply ingrained in our communities, that challenging it often seems futile. For alcohol and other drugs/harm reduction workers there is the added complexity presented when we consider the nature of our daily work – a stream of people presenting to services with more immediate concerns than the fact that our communities value them less based solely on their choice of intoxicant. The trap however, is that all too often the same pressing concerns presented to us on a daily basis, are at the very least, partly the result of stigma and marginalisation.
So do something
In short our work must not only be personal, it must also be political. This doesn’t mean that we have to all rush out and become overnight activists (but if you want to, that would be great too, the more angry letters the better I say!)
What it does mean however, is that we can ensure in our personal interactions with people accessing our service that we:
- Raise awareness about stigma and it’s effects
- Identify with them their personal experience of stigma
- Challenge self stigmatising beliefs that reflect the stereotypes and prejudices that are so pervasive in our communities
- Ensure people accessing the service know their rights and how they can address infringements upon those rights. Useful information can include knowing where to go to complain about poor treatment or discrimination.
- Inform them of any collectives such as peer driven organisations that work to address the issue of stigma.
Most of all we need to reflect upon our own understanding of stigma and challenge any prejudices that we may hold. We are after all only human and have often been subjected to the same forces that have helped to shape the dominant stigmatising norms within our communities.
To do all of this we need to ensure that we are adequately resourced.
Three Stigma Resources for AOD/Harm Reduction workers
It is with this in mind that I recommend the following three excellent resources regarding stigma:
Seeking to pinpoint the origins of what is a socially constructed exclusion of a proportion of our community, this excellent resource developed by the Australian Injecting and Illicit Drug Users League (AIVL) examines the social, economic, religious and political factors that have influenced the social norms and attitudes regarding drug users and drug use. This resource is an incredibly important starting point in learning the antecedents of today’s stigmatisation of drug users.
Developed by the United Kingdom Drug Policy Commission (UKDPC), ‘Getting serious about stigma’, addresses the often widely held misconceptions about people who use drugs and examines the implications this can have for people who experience drug dependency. The report’s recommendations are structural in nature, advocating for media campaigns alongside improved worker training and legislative changes addressing key laws that reinforce stigma and hinder people from reaching their goals in changing drug use behaviours.
The Harm Reduction Coalition in the U.S. has developed a half day training program designed to improve workers understanding and skills when it comes to addressing stigma. (Now that’s some training I would love to attend). They have also very generously made the curriculum materials that support the training available on their website. While they are on their own no replacement for what I am sure would be a fantastic training experience, the curriculum materials provide a handy resource to reflect upon and learn about stigma within our own workplaces.